Pilot Project on Resident Knee Exam Teaching and Competency Assessment

The Statewide Musculoskeletal Group has been working on a residency curriculum pilot project for the past 18 months, "Family Medicine Resident Knee Exam Skills Teaching and Assessment: A Pilot Project." The group includes Kathleen Carr, MD (Chair), Marguerite Elliott, DO, Sue Kostka, RN, MS, Craig Gjerde, PhD, Jeff Patterson, DO and Jerry Ryan, MD from Madison, Dennis Breen, MD from Eau Claire, and Dan Smith, DO from Fox Valley.

The group first developed a standardized knee exam for an adult patient complaining of knee pain, drawing on evidence in the literature for the various exam components. We created a video of this standardized exam with the help of Marijka Hambrecht, Matt Fleming, Janet Reschke and Michelle Wood, and residents, Ryan Grandgenett, MD and Steve Soneral, DO. We also developed a checklist form for the knee history and physical exam.

The pilot project includes three resident sessions throughout the year with the 2004-05 Madison, Eau Claire and Fox Valley interns. The interns were all videotaped performing a history and physical exam of the knee early in the year. The number of history and physical exam items on the checklist that they asked or performed correctly was tabulated and will be compared to their performance on a post-teaching videotaped session at each site this spring. A mid-year multimedia teaching session includes a faculty-led PowerPoint presentation on the knee history and exam, viewing of the standardized knee exam video, and hands-on practice of the knee exam with direct faculty observation and feedback. The sessions have been very highly rated by the residents so far.

The results of the pilot project will be presented at the Society of Teachers of Family Medicine meeting in New Orleans in May. Thank you to all residency faculty and staff who have accommodated our requests for time in the interns' curriculum this year.

The group is currently working on similar teaching tools for the shoulder and ankle/foot, and will present these three history and exam skills teaching and assessment "packages" at the Statewide Education Committee and GMEC meetings in May. We have been charged with facilitating the implementation of this resident competency assessment and documentation model at all of the statewide DFM residencies with the 2005-06 interns. We look forward to collaborating with faculty and staff at all sites this spring to accomplish this goal.

If you are interested in participating in the planning process, please contact Kathleen Carr at Kathleen.Carr@fammed.wisc.edu, or 608-262-8090. The knee exam video and our meeting agendas and minutes are available for your review on our Inside website.